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There is a long-held belief among dental consultants that we must never give prices over the phone when a patient asks. Instead, we’ve created an elaborate way of not answering the question, and trying to get the patient in. I know, because in my first book, Everything is Marketing, I gave exactly that same advice.

Well, times are changing. People are very used to being able to find the price, and the cheapest price, for almost anything. Right there in their hand is a smartphone that can find the cheapest TV, car, dinner or hotel.

The problem in dentistry is compounded by the fact that fees vary so much from practice to practice, and UCF’s are radically different depending on what city or town you’re in. And I know some dentists in Beverly Hills who charge a separate fee to put on a temporary (which is why they don’t want to get a CEREC–there’s goes that extra income!)

What’s a patient to do? Especially since the whole dental insurance coverage issue is just as confusing to them, and hard for them to understand that it’s not health insurance at all, but some variation of a discount plan on basic care.

I still believe that when a patient is asking what a crown costs, they are really asking if they can trust you not to overcharge them, since they can’t come in and start pulling charts to figure out if you’re a good clinician or not. (Even if they knew what to look for, HIPPA wouldn’t allow it!) So they don’t know what else to ask, so they ask for prices. And many front desk team members will just give up the cost right away, without establishing any value or clarifying that costs depend on diagnosis. And that’s not good either.

Now, some patients live on a very tight budget. Quite a few of them, actually. So cost is a huge factor when it comes to dentistry and accepting treatment. I don’t really have to tell you that. And not everyone values dentistry the same way that you and I do. Some people just want to be able to chew or get out of pain.

And I also understand that most of you don’t want patients who are looking for the cheapest dentist. You don’t want to be that, and you don’t want people to expect that. But somehow, you’ve got to still get them to come into the practice and find out what a remarkable experience you give them, so that they start to believe you are worth the cost.

There is no simple answer here, but a large part of the solution is to have someone very skilled working at your reception, who knows how to listen, how to empathize, and how to effectively create a great first impression of the practice, and persuade someone to come in to experience it for themselves.

And then it comes down to the words. In many cases, rather than being totally evasive, you can give a range of what something would cost, depending on their individual condition. And it’s still critical to explain to people that it’s impossible to diagnose over the phone. But a root canal is a root canal, and 9 times out of 10 you are going to charge exactly the same amount each time you do it. So they know you’re being evasive when you don’t just tell them, and that doesn’t build trust.

In short, your front desk person has to be comfortable talking about cost, while making sure to build value over the phone, and inviting the patient to come in and see for themselves. If she is confident that she is working for a dentist who does high quality work in a comfortable environment at a reasonable price, then she is going to project that over the phone, and the patient will sense it. And then, talk about the range of what a treatment would cost, and also make clear that an initial exam is free or a very low cost.

Of course, you won’t get everyone in. That’s the reality. And not every patient is a good fit for the practice. But you can improve your odds. And I’ve become convinced that we need to not only get comfortable talking about fees over the phone, but we need to get good at it.

I’m going to dive much deeper into this whole question of maximizing the front desk results in my next webinar, with special guest Laura Hatch, who has helped create the front desk environment that built two multi-million dollar practices, and who know teaches those skills in her fantastic video course, Front Office Rocks. The webinar is Friday, January 12th at 11am Pacific time. You can register by clicking here, and even if you can’t make it, as long as you register you’ll be sent a recording of the webinar.

It’s going to be extremely valuable for anyone building a practice, so don’t miss this one!

If you were lucky, you had a chance to hear Gary Takacs and I do a webinar on how to radically reduce no-shows in your practice. My marketing team enjoyed it so much that they thought it would be good to boil the points down to a tip sheet. If you’re interested in laying your hands–or at least eyeballs–on the aforementioned sheet, click here!

To see the whole webinar and a whole slew of other great resources, sign up at our Futuredontics page here.

I’m not talking about treatment codes here. I’m talking about how to stem the revenue erosion that many practices are facing by accepting dental plans, and I’m doing it in a webinar with my good friend Bernie Stoltz, the CEO of Fortune Management. His company has helped more than two thousand practices solve this challenge and build strong practices with happy patients.

We will go into alternative methods of satisfying your patients needs without compromising your profitability, and how to make choices about accepting plans as part of an overall strategy. If you’re hoping to thrive in the next decade, this webinar is a must!

Here’s what we know already: “Insurance” is now the #1 reason people pick a new dentist. This game-changing consumer behavior is hurting profits at practices nationwide. Join me and Bernie and learn new, better ways to leverage your insurance and dental plan offerings to maximize production and patient satisfaction. Here are some highlights:

Why insurance is your #1 hidden marketing expense

Best insurance strategies for 2017 & beyond

Tips on choosing the right plans for your practice

Smart new alternatives to traditional dental insurance

Don’t miss this informative, fast-paced presentation followed by a live Q&A session. And as always, if you register but can’t attend, you’ll be sent a link to the recording of the session. See you online!

When most dentists ask me this, they usually are asking about their advertising spending, not their marketing, which encompasses much more. And my answer is that it’s more likely that they’re probably not spending enough, or they’re spending it in the wrong places.

Tracking your results is essential to being able to answer this question. You need to know the source of your patients, and this can be done primarily by making sure that the source–either promotion or existing patient–that a patient came from is entered in your PMS, so that you can run a production report on your advertising results. And, more and more, you can track results back a few steps from there.

For example, with direct mail you can use a unique phone number that forwards to your main line, so that you can track exactly how many calls you received, not just how many patients you acquired. And with Google, Yelp! and other digital advertising you can see a lot of data, particularly how many people clicked on your ad, so you can compare that to the new patient count.

But let’s get back to the main question. There are only two reasons why you might be spending too much overall on advertising and promotion:

1. Your schedule is full for the next three to six weeks. If you can’t see new patients within two or three days at the most, then you will be wasting money on advertising;

2. Word of mouth is not your number one source of new patients. This the clearest indicator that the experience of being one of your patients does not inspire people to recommend you, and you need to fix that.

As far as your marketing/advertising budget, there are two ways to look at it: as a dollar amount, or as a percentage of your annual revenue.

As a rule of thumb, 5% of your annual revenue is a reasonable amount to spend on your advertising. I know thriving practices that spend as high as 8%, because they know that their profitability is higher once they have paid their fixed expenses, so they can afford to invest in growth.

As a dollar amount, your marketing costs should range from $20,000 to $40,000 per year. This would be higher with a startup practice–perhaps double that amount–because you need to start building a patient base.

Here is how I would break down the spending:

1. Your Website. This is the cornerstone of your practice promotion. Even word of mouth patients are likely to visit your website before calling the practice. And this is important to remember–your website is a work in progress. It’s never done, because Google is looking every day at it, seeing what has changed. So you need a dynamic website, where content changes automatically and you can add and change content easily yourself. For more on this, read my previous blog on websites.

Cost: $3000 for a new website, $75 per month to host and maintain it.

2. Social Media.This is a marketing cost, primarily. You should be paying someone in your office to add posts, request them from patients, monitor and respond to them, and also keep track of online reviews. This cost is part of their pay, but 12-15 hours a month should be dedicated to this. There are outside services that can do this, but they still need someone monitoring them.

Cost: $250 per month.

3. Discounts. This is part of your marketing cost, and often people forget that. If you’re doing a free exam, cleaning and x-rays, the cost is not high if you have digital radiography, but it’s not nothing. You still have to pay your hygienist.

Cost: $300 per month, assuming 10 new patients attracted this way.

4. Insurance plans. Dentists often forget that this is a marketing cost. You are discounting your work to attract patients through the plan. This number is impossible for me to estimate for you, but I want you to be mindful of it as a promotional expense. And you can calculate it fairly easily, since you know what you collect versus what you would have.

5. Advertising. This could be anything from bidding on AdWords to advertising on Yelp! or Facebook, doing direct mail, local newspaper ads, or even radio or TV. Or referral programs like 1-800-DENTIST. I believe in doing everything that works. Keep in mind that the lifetime value of a new patient to your practice is substantial, and worth investing in. If you don’t get that yet, watch this video.

Cost: $1000 to 3000 per month.

Other factors that would increase your advertising cost:

1. You don’t have storefront visibility to your practice. This could add 20% or more to your budget.

2. You have limited hours, or less convenient hours than your local competitors.

3. You don’t take any emergency patients.

Anything that limits the convenience and appeal to a new patient is going to diminish your results, making advertising more expensive. What else could you be doing wrong? Several things.

Let’s start with your front desk. If you have someone who is not personable, or who is over-screening the patients, or generally not skilled at converting callers into patients who show up, your advertising spend is being largely wasted. Fix that first.

You could also be spending too much on a particular marketing approach. Every medium will have diminishing results eventually, either as you increase the budget to too high a level, or over the course of time. Direct mail, for example, will almost always over-saturating a market eventually, and you need to stop for a few months. (1-800-DENTIST would be an exception, because we’re constantly modifying our advertising approach to compensate for this.)

You could be using a promotional approach that gets lots of calls, with very little conversion into real patients, or low production on them. The wrong type of patients means either the message is wrong, or you aimed at the wrong target audience, or the medium is wrong. I consider Groupon a classic example of this, and though a few people made it work, I’m glad it’s faded away from the dental world.

My main suggestion is to get professional help. Advertising as an industry is changing at a dizzying pace, and it’s all any of us can do to keep up. And get someone who works in the dental industry. People behave very differently when it comes to dentistry, ( in case you haven’t noticed!) and you want a resource that understands that.

A good practice consultant and also your product distributor rep should both be resources for you to find the best help, and to make sure you’re getting the best results.

Most people reduce Darwinism to “survival of the fittest,” but his theory actually states that the species that survive are the ones who most effectively adapt.

And let’s face it–humans are not the fittest species. We couldn’t outrun a housecat, we swim slower than a goldfish, we need clothing to keep from freezing to death. Half of us need glasses to even see. And yet we dominate the planet, because we are highly adaptive.

But like most species, we only adapt when we need to. We resist it, we ignore it, and sometimes we legislate against it, but change comes anyway. (Witness the battle going on over Uber in various states.)

Well, in dentistry today, we need to evolve.

Because my company deals with dental consumers all over the country, dentists ask me what I think the future of dentistry will be. The answer may vary somewhat depending on where they are, but one of the things I always tell them is that I believe that within a generation the solo practice will not be a sustainable business model. There are forces at work that never existed before, not just trends but tectonic shifts.

These are the main ones:

Corporate dentistry is growing at 15% annually

Convenient hours are the norm for most service businesses

Consumers use and trust online reviews in ever-increasing numbers (translation: word of mouth has gone digital)

Discretionary income has shrunk for every segment of American society except the top 10%

Need I go on?

I meet dentists every week who are hoping to coast to the end of their practice run without upgrading their facility, refreshing their patient base, or offering any sort of convenient hours, and hope to get a nice payday when they sell their practice. Would you put your house on the market without painting it, doing some landscaping, and getting rid of that scary couch in the living room? Yet this is what dentists are doing all across the country, and what will happen is someone won’t buy the practice, they’ll just open across the street with a new facility, convenient hours, same day dentistry, and they’ll vacuum half the patients out of that practice in a year or two.

Just because you don’t see big changes coming doesn’t mean they’re not looming on the horizon. For the first time in the 30 years I’ve been working in dentistry, I’ve witnessed dentists losing their entire practice, having virtually nothing to sell at the end. Others have declined 30% in a single year (2008) and then 10% every year thereafter. Many others are still surviving, and some are thriving. But times have really changed.

What can/should you do?

1. Consider bringing in an associate or two. And maybe a specialist or two. You have a million-dollar surgical facility that you’re using 35 hours a week, if that. Get someone else in there.

2. Take a close look at your patient base. Does it merit taking some insurance plans? I know that the goal for many years was to be a completely fee-for-service practice, but I’m not seeing that as viable for most practices in the years ahead. Dr. Mike Barr, in this brilliant blog post, argues against that with a very good strategy, but it involves a determined effort to evolve and change.

3. Tech up. I’m mystified that when a dentist doesn’t get that same day dentistry like CEREC is not a consumer benefit of major proportions. What patient wants two visits instead of one? They don’t want the first one!

4. Offer more convenient hours. Test them to see what your patient base needs. Early mornings, evenings, Saturdays, see what fills up fastest in the schedule.

4. Have a comprehensive digital strategy. This starts with a rock solid, dynamic website, but doesn’t end there. You need a strategy for online reviews* and social media.

5. Network. You and your team need to interact with your community. You can’t just take another clinical course and hope patients will get all excited about your new skill level and start lining up outside.

6. Get more efficient. Use digital communications like PatientActivator. Get a practice coach. Every successful athlete has at least one coach, simply because they don’t know what they’re doing wrong and how they can get better. A good consultant can get you and your team there faster.

Dentistry can be a fantastic profession for many years, perhaps many generations to come, but it’s evolve or die, just like everything else on the planet.

*I’m doing a webinar on online reviews this week entitled “Yelp! The Dentist Survival Guide”. It happens on Thursday at 11am PST. It’s free, and you can register by clicking here.

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